Phenylephrine

Registered South African indications:

• Mucosal congestion

Contraindications 

• Hypersensitivity to the active ingredient or any of its excipients
• Hyperthyroidism
• Aneurysm
• Hypertension
• Arteriosclerosis
• Ventricular tachycardia
• Myocardial disease
• Bradycardia
• Coadministration with monoamine oxidase inhibitors or within 14 days of their use
• Coadministration with tricyclic antidepressants
• Coadministration with guanethidine and similar adrenergic neurone-blocking agents
• Coadministration with reserpine and methyldopa

Caution

• Pregnancy
• Breastfeeding
• Arrhythmia
• Occlusive vascular disease
• Arteriosclerosis
• Diabetes mellitus
• Prostatic hypertrophy
• Closed angle glaucoma
• Prolonged use
• Excessive use

Forms avail. in SA and covered in this monograph: dro

Mucosal congestion

• Nasal (dro): 1% sol. Apply 2-3 drops, 4hrly

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Restrict duration of use to 2-3 days to prevent rebound rhinitis

Paed. forms avail. in SA and covered in this monograph: dro

Mucosal congestion

Younger than 6 years

• Not established for use

Between 6-12 years

• Nasal (dro): 0.25% sol, 2-3 drops, 4hrly

Older than 12 years

• See adult dosage

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Restrict duration of use to 2-3 days to prevent rebound rhinitis

Pregnancy

• Caution
• Safety in pregnancy has not been established

Breastfeeding

• Caution
• It is not known if phenylephrine (nasal) is excreted in breast milk

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended 

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache
• Anxiety
• Restlessness
• Tremor
• Insomnia
• Confusion
• Irritability
• Weakness
• Psychotic states
• Cerebral haemorrhage
• Dizziness
• Fainting

Cardiovascular Disorders

• Hypertension
• Palpitations
• Reflex bradycardia
• Cardiac arrhythmias
• Vasoconstriction
• Cardiac arrest
• Angina
• Hypotension

Respiratory Disorders

• Rhinitis medicamentosa
• Pulmonary oedema
• Dyspnoea
• Increased nasal discharge
• Sneezing

Gastrointestinal Disorders

• Nausea and vomiting
• Reduced appetite
• Stinging of the mouth and throat
• Hypersalivation

Genitourinary Disorders

• Difficulty with micturition
• Urinary retention

Endocrine and Metabolic Disorders

• Altered glucose metabolism 

Skin and Subcutaneous Tissue Disorders

• Nasal irritation
• Nasal dryness
• Flushing

Others

• Sweating

• Monoamine oxidase inhibitors
• Tricyclic antidepressants
• Adrenergic neurone-blocking agents
• Centrally acting antiadrenergic agents
• Guanethidine
• Reserpine
• Maprotiline
• Digoxin
• Alpha-methyldopa

None routine

Phenylephrine  is a sympathomimetic amine that acts agonistically at alpha-1 adrenoreceptors with virutally no beta adrenergic activity. Binding at these receptors causes vasoconstriction and decreases nasal blood flow which results in alleviation of nasal congestion. 

Nasal drops (per 10ml) 25mg

• Adco-Naphensyl Nose Drops 0.25% (Adcock)

Nasal drops (per 10ml) 100mg

• Adco-Naphensyl Nose Drops 1.0% (Adcock)

Nasal drops (per ml) 2.5mg

• Universal nasal drops solution (Litha) originator

Also available in the following forms: Injection and eye drop.

COMBINATIONS PREPARATIONS

Phenylephrine/ Naphazoline nitrate 

Nasal drops (per 10ml) 25mg/2.5mg

• Nasdro (Adcock)  
• Terine nasal drops (Gulf Drug)

Nasal drops (per 25ml) 62.5mg/6.25mg

• ENT (Adcock)

Nasal spray (per 25ml) 62.5mg/6.25mg

• ENT (Adcock)

Phenylephrine/ Dimetindene maleate 

Nasal gel (per 100g) 250mg/25mg

• Vibrocil-S (Novartis) originator

Phenylephrine/ Neomycin sulphate/ Dimetindene maleate

Nasal spray 250mg/350mg/25mg 

• Vibrocil (Novartis) originator

Nasal gel 250mg/350mg/25mg 

• Vibrocil (Novartis) originator